The Mental Capacity Act 2005 Implications for Front Line Staff. Richard Williams Professor of Mental Health Strategy, University of Glamorgan Professor of Child and Adolescent Mental Health, University of Central Lancashire

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A person must be assumed to have capacity unless it is established that they lack capacity

A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success

A person is not to be treated as unable to make a decision merely because he makes an unwise decision

An act done, or decision made, under this Act for or oin behalf of a person who lacks capacity must be done, or made, in his best interests

Before the act is done, or the decision is made, regard must be had to whether the purpose for which it is needed can be as effectively achieved in a way that is less restrictive of the person’s rights and freedom of action

‘For the purposes of this Act, a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain’

This means that a person lacks capacity if:

They have an impairment or disturbance (for example, a disability, condition or trauma) that affects the way their mind or brain works, and

The impairment or disturbance means that they are unable to make a specific decision at the time it needs to be made

‘Clearly, in emergency situations (for example, where a person collapses with a heart attack or for some unknown reason and is brought unconscious into a hospital), urgent decisions will have to be made and immediate action taken in the person’s best interests’

‘In these situations, it may not be practical or appropriate to delay the treatment while trying to help the person to make their own decisions, or to consult with any known attorneys or deputies’

‘However, even in emergency situations, healthcare staff should try to communicate with the person and keep them informed of what is happening’

Section 5(1) of the Act provides possible protection for actions carried out in connection with care and treatment carried out on behalf of someone who is believed to lack capacity for the action so long as it is in that person’s best interests and that includes diagnostic or other procedures is included in treatment